Healthcare Provider Details

I. General information

NPI: 1346230448
Provider Name (Legal Business Name): JOSEPH ZUCKERMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 04/02/2021
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 2ND AVE SUITE 21
NEW YORK NY
10016
US

IV. Provider business mailing address

303 2ND AVE SUITE 21
NEW YORK NY
10016
US

V. Phone/Fax

Practice location:
  • Phone: 212-598-6573
  • Fax:
Mailing address:
  • Phone: 212-598-6573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number157703
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: